Essential Hypertension vs. Secondary Hypertension Among Children
Essential Hypertension vs. Secondary Hypertension Among Children
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DOI：
10.1093/ajh/hpu083
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发表时间：
2015-01-01
影响因子：
3.2
通讯作者：
Boerwinkle, Eric
中科院分区：
文献类型：
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作者：
Gupta-Malhotra, Monesha;Banker, Ashish;Boerwinkle, Eric
目的是确定儿童原发性高血压的比例和相关性在三级儿科高血压门诊。方法我们评估了423名儿童，并收集人口统计学和临床病史的回顾性图表审查。方法我们确定了275（65%）高血压儿童（根据“关于诊断，评估，和儿童和青少年高血压的治疗”），来自423名因血压升高病史而被转诊到诊所的儿童。其余患者血压正常（11%）、白色被毛高血压（11%）、高血压前期（10%）和待诊断（3%）。在275名高血压儿童中，43%（n = 119;男孩= 56%;中位年龄= 12岁;范围= 3-17岁）患有原发性高血压，57%（n = 156;男孩= 66%;中位年龄= 9岁;范围= 0.08-19岁）患有继发性高血压。与继发性高血压患者相比，原发性高血压患者的诊断年龄明显更大（P = 0.0002），高血压家族史更强（94% vs. 68%; P < 0.0001），早产发生率更低（20% vs. 46%; P < 0.001）。有一个双峰分布的诊断年龄在那些继发性hypertension.CONCLUSIONSThe原发性高血压的表型可以呈现早在3岁，是高血压的主要形式在儿童6岁后。在高血压患儿中，原发性高血压患儿年龄较大，高血压家族史较强，早产发生率较低。
BACKGROUNDThe aim was to determine the proportions and correlates of essential hypertension among children in a tertiary pediatric hypertension clinic.METHODSWe evaluated 423 consecutive children and collected demographic and clinical history by retrospective chart review.RESULTSWe identified 275 (65%) hypertensive children (blood pressure > 95th percentile per the "Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents") from 423 children referred to the clinic for history of elevated blood pressure. The remainder of the patients had normotension (11%), white coat hypertension (11%), prehypertension (10%), and pending diagnosis (3%). Among the 275 hypertensive children, 43% (n = 119; boys = 56%; median age = 12 years; range = 3-17 years) had essential hypertension and 57% (n = 156; boys = 66%; median age = 9 years; range = 0.08-19 years) had secondary hypertension. When compared with those with secondary hypertension, those with essential hypertension had a significantly older age at diagnosis (P = 0.0002), stronger family history of hypertension (94% vs. 68%; P < 0.0001), and lower prevalence of preterm birth (20% vs. 46%; P < 0.001). There was a bimodal distribution of age of diagnosis in those with secondary hypertension.CONCLUSIONSThe phenotype of essential hypertension can present as early as 3 years of age and is the predominant form of hypertension in children after age of 6 years. Among children with hypertension, those with essential hypertension present at an older age, have a stronger family history of hypertension, and have lower prevalence of preterm birth.